10D2244438 CLIA NUMBER - WALMART HEALTH #1083

Laboratory Demographics

CLIA Number: 10D2244438

Facility Name: WALMART HEALTH #1083

Facility Address:
6830 NORMANDY BLVD UNIT 100
JACKSONVILLE, FL
ZIP 32205
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Facility Phone Number: 479 360-3125

Facility Type: Community Clinic

Certificate Type: Waiver

NPI Number: 1861419236

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	10D2244438
LAB Type	Community Clinic
Facility Name	WALMART HEALTH #1083
Street	6830 NORMANDY BLVD UNIT 100
City	JACKSONVILLE
State	FL
ZIP	32205
Phone	479 360-3125
CertificateType	4
CertificateEffectiveDate	12/1/2023
CertificateExpirationDate	11/30/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024